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Intervention Alone (intervention + alone)
Selected AbstractsEffects of a yoga breath intervention alone and in combination with an exposure therapy for post-traumatic stress disorder and depression in survivors of the 2004 South-East Asia tsunamiACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010T. Descilo Descilo T, Vedamurtachar A, Gerbarg PL, Nagaraja D, Gangadhar BN, Damodaran B, Adelson B, Braslow LH, Marcus S, Brown RP. Effects of a yoga breath intervention alone and in combination with an exposure therapy for PTSD and depression in survivors of the 2004 South-East Asia tsunami. Objective:, This study evaluated the effect of a yoga breath program alone and followed by a trauma reduction exposure technique on post-traumatic stress disorder and depression in survivors of the 2004 Asian tsunami. Method:, In this non-randomized study, 183 tsunami survivors who scored 50 or above on the Post-traumatic Checklist-17 (PCL-17) were assigned by camps to one of three groups: yoga breath intervention, yoga breath intervention followed by 3,8 h of trauma reduction exposure technique or 6-week wait list. Measures for post-traumatic stress disorder (PCL-17) and depression (BDI-21) were performed at baseline and at 6, 12 and 24 weeks. Data were analyzed using anova and mixed effects regression. Results:, The effect of treatment vs. control was significant at 6 weeks (F2,178 = 279.616, P < 0.001): mean PCL-17 declined by 42.5 ± 10.0 SD with yoga breath, 39.2 ± 17.2 with Yoga breath + exposure and 4.6 ± 13.2 in the control. Conclusion:, Yoga breath-based interventions may help relieve psychological distress following mass disasters. [source] Mailed treatment to augment primary care for alcohol disorders: A randomised controlled trialDRUG AND ALCOHOL REVIEW, Issue 1 2009DAVID KAVANAGH Abstract Introduction and Aims. Remote delivery of interventions is needed to address large numbers of people with alcohol use disorders who are spread over large areas. Previous correspondence trials typically examined its effects as stand-alone treatment. This study aimed to test whether adding postal treatment to general practitioner (GP) support would lower alcohol use more than GP intervention alone. Design and Methods. A single-blind, randomised controlled trial with a crossover design was conducted over 12 months on 204 people with alcohol use disorders. Participants in an immediate correspondence condition received treatment over the first 3 months; those receiving delayed treatment received it in months 3,6. Results. Few participants were referred from GPs, and little intervention was offered by them. At 3 months, 78% of participants remained in the study. Those in immediate treatment showed greater reductions in alcohol per week, drinking days, anxiety, depression and distress than those in the delayed condition. However, post-treatment and follow-up outcomes still showed elevated alcohol use, depression, anxiety and distress. Greater baseline anxiety predicted better alcohol outcomes, although more mental distress at baseline predicted dropout. Discussion and Conclusions. The study gave consistent results with those from previous research on correspondence treatments, and showed that high levels of participant engagement over 3 months can be obtained. Substantial reductions in alcohol use are seen, with indications that they are well maintained. However, many participants continue to show high-risk alcohol use and psychological distress.[Kavanagh D, Connolly JM. Mailed treatment to augment primary care for alcohol disorders: A randomised controlled trial. Drug Alcohol Rev 2009;28:73,80] [source] Two studies of proximal outcomes and implementation quality of universal preventive interventions in a community,university collaboration contextJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 5 2002Richard Spoth Here we present the results from two longitudinal studies of competency-training interventions that entailed community,university collaboration intended to enhance implementation quality. In Study 1, 22 rural schools were randomly assigned to a family-focused intervention or a minimal contact control group. In Study 2, 36 rural schools were randomly assigned to a family-focused preventive intervention combined with a school-based intervention, the school-based intervention alone, or a minimal contact control group. In both studies, observers rated adherence to intervention protocols. Results showed that, on average, high levels of observer-rated adherence were attained in both studies. Analyses of the relationship between observer-rated adherence scores and proximal outcomes showed limited evidence of poorer outcomes associated with lower-adherence groups. Overall, findings highlight the benefits of community,university collaboration intended to facilitate high levels of intervention adherence. The need for a framework guiding a collaborative implementation research agenda is discussed. © 2002 Wiley Periodicals, Inc. [source] Evaluation of a primary care-oriented brief counselling intervention for obesity with and without orlistatJOURNAL OF INTERNAL MEDICINE, Issue 4 2006W. S. C. POSTON Abstract. Objective., There is a significant need for an obesity treatment model suitable for the primary care environment. We examined the effectiveness of a brief counselling intervention alone, in combination with orlistat, and drug-alone in a 12-month randomized-clinical trial at a medical school obesity centre. Methods., Participants (N = 250) with body mass index (BMI) ,27 were randomized. Changes in body weight, lipids, blood pressure and serum glucose were examined. Drug adherence and attendance were also evaluated. Results., Completers analysis was conducted on 136 participants with data at baseline, 6 and 12 months and intention-to-treat analyses (ITT) for the total sample. Amongst completers, participants in the drug only (P = 0.012) and drug + brief counselling (P = 0.001) groups lost more weight (mean ± SD: ,3.8 ± 5.8 kg and ,4.8 ± 4.4 kg, respectively) than participants in the brief counselling only group at 6 months (,1.7 ± 3.3 kg), but there were no significant group differences at 12 months. ITT model results were similar to completers at 6 months and remained significant at 12 months, but the weight losses were more modest (<3 kg) for both groups receiving orlistat. For brief counselling alone, participants gained weight (1.7 ± 4.2 kg). Cardiovascular disease (CVD) parameter changes were negligible. Conclusions., Pharmacotherapy alone or combined with brief counselling resulted in modest weight losses that had minimal impact on cardiovascular parameters, but were greater than brief counselling alone. Whilst brief interventions and primary pharmacotherapy have been suggested as viable treatments for implementation in primary care settings, our study suggests that such minimal interventions provide minimal benefits. [source] A multivitamin supplementation and education intervention as an effective means of increasing multivitamin use among postpartum women of Mexican originPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2007Kathleen M. O'Rourke Summary Postpartum Hispanic women in the USA are at elevated risk for neural tube defects in subsequent pregnancies from the combined effects of ethnicity, folate depletion from the prior pregnancy and lactation, and high parity rates with short inter-birth intervals. This study evaluated an education programme and distribution of a 3-month starter package of multivitamins among Hispanic women attending nutrition clinics for low-income women in El Paso, Texas. At 1,6 weeks postpartum, 329 subjects were selected to receive education only, multivitamins only, education and multivitamins, or no intervention. Multivariable regression obtained odds ratios (OR) and 95% confidence intervals [CI] to measure the association between intervention status and self-reported multivitamin use at least four times per week at 6 and 12 months postpartum, while controlling for potential confounding variables. Multivitamin distribution was related to consumption at both 6 months (OR = 3.5 [95% CI 1.1, 11.2]) and 12 months (OR = 6.5 [95% CI 1.5, 28.3]). Multivitamins plus education was most effective in increasing multivitamin use at both periods: 6 months (OR = 4.0 [95% CI 1.53, 11.7]) and 12 months (OR = 6.4 [95% CI 1.7, 24.2]). At enrolment, 66% of women regularly took vitamins, and approximately 35% took them at both 6 and 12 months postpartum. The education intervention alone was not associated with multivitamin use at either 6 months (OR = 0.79 [95% CI 0.3, 2.4]) or 12 months (OR = 3.1 [95% CI 0.8, 12.1]). Multivitamin use declines precipitously during postpartum at the time Hispanic women may be susceptible to a subsequent pregnancy. This study provides evidence that multivitamin starter packs sustain multivitamin usage up to 1 year postpartum for a specific high-risk group, but the effect of educational intervention alone should be further studied. [source] Thoroughness of skin examination by melanoma patients: Influence of age, sex and partnerAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 3 2009Susan L Boone ABSTRACT The aim of this study was to determine the thoroughness of deliberate skin examination by people with a history of melanoma. Patients were randomized into one of two conditions: either to receive the brief educational and skills training intervention alone or as a couple with their spouse or cohabiting partner. Subjects recorded concerning lesions on body maps. At the 4-month visit, a total body skin examination was performed by a dermatologist blinded to the subjects' condition and to their recorded responses. The skin surface was divided according to the region's visibility during skin self-examination and sexual connotations: visible/not sexually sensitive, non-visible/not sexually sensitive and sexually sensitive. The primary point of comparison was missed lesions, defined as the difference between lesions recorded by the subjects and their partners and those recorded by the dermatologist. Among 130 participants, 56 subjects reported partner assistance while performing SSE. Participants missed more lesions in sexually sensitive areas than in the other regions. With the increasing age of the patient, the number of missed lesions in non-visible/not sexually sensitive and sexually sensitive areas decreased. Male patients assisted by female partners missed fewer lesions in all three regions than female patients assisted by male partners. In easily visible areas, male patients missed significantly fewer lesions than female patients (P = 0.01). Older couples performed more thorough partner-assisted skin examinations in non-visible and sexually sensitive areas than younger couples. Male patients who were assisted by female partners performed more thorough partner-assisted skin examinations than female patients assisted by male partners. [source] Reversal of trichotillomania with aripiprazoleDEPRESSION AND ANXIETY, Issue 6 2008B.Ed., Don Jefferys A.M., F.A.A.E.T.S, M.A.C.E., M.A.P.S., Ph.D. Abstract Trichotillomania (TTM) is a common psychiatric illness with marked chronicity and comorbidity that significantly impacts on psychosocial functioning and physical features of the sufferer. Treatment studies, to date, using behavioral and pharmacological interventions alone or simultaneously, are equivocal with few showing a sustained cessation of hair-plucking. In this report of a single patient with treatment resistant TTM, the sole use of the atypical neuroleptic Aripiprazole resulted in a cessation of hair-plucking maintained, at the time of reporting, for a period of 24 months. This finding, a first with Aripiprazole, warrants further investigation of this drug in the treatment of TTM. Depression and Anxiety 0:1,4, 2007. © 2007 Wiley-Liss, Inc. [source] The implications of physical activity in patients with chronic heart failureNURSING IN CRITICAL CARE, Issue 1 2004Catherine T Mondoa Summary ,,The clinical syndrome of chronic heart failure is increasingly prevalent. It can be considered a multiorgan disorder that may exert a negative physical and psychological influence on a patient ,,Medication and surgical intervention have important roles to play and have certainly improved both morbidity and mortality in this field, but clearly these interventions alone are not enough ,,Excessive resource utilization for this group of patients has provided added impetus to research into non-pharmacological interventions. These encompass dietary and other lifestyle measures, including smoking cessation and exercise ,,Exercise has been shown to favourably affect the functional capacity and quality of life. There is also emerging evidence that it reduces mortality ,,In the absence of contraindications, regular endurance exercise coupled with strength training is undoubtedly beneficial ,,As with other cardiovascular research, there is a trend towards recruiting middle-aged males. This effectively means that practitioners need to be cautious when evaluating and/or implementing research evidence ,,By addressing the implications of physical activity for deconditioned patients with chronic heart failure, a holistic therapeutic regimen is fostered. This has been shown to improve the quality of life of patients and to enhance the quality of service delivered to this patient group [source] Culture theorizing past and present: trends and challengesNURSING PHILOSOPHY, Issue 4 2010Helen E.R. Vandenberg RN MSc (Nursing) Abstract Over the past several decades, nurses have been increasingly theorizing about the relationships between culture, health, and nursing practice. This culture theorizing has changed over time and has recently been subject to much critical examination. The purpose of this paper is to identify the challenges impeding nurses' ability to build theory about the relationships between culture and health. Through a historical overview, I argue that continued support for the essentialist view of culture can maintain a limited view of complex race relations. I also argue that attempts to apply culture theory, without knowledge of important historical, political, and economic factors, has often resulted in oversimplified versions of what was originally intended. Furthermore, I argue that individual-level interventions alone will be insufficient to address health inequities related to culture. Despite new critical conceptualizations of culture and the uptake of cultural safety, nursing scholars must better address the broader organizational, population, and political interventions needed to address inequities in health. I conclude with suggestions for how nurses might proceed with culture theorizing given these challenges. [source] The patient with cardiovascular disease: Treatment strategies for preventing major eventsCLINICAL CARDIOLOGY, Issue S2 2006Michael Cuffe M.D. Abstract An abundance of clinical data exists to support the ability of pharmacologic interventions to reduce risk for vascular events significantly; however, there remains a gap between this evidence and current clinical practice. Recent data from large-scale, placebo-controlled statin trials demonstrate that these agents dramatically reduce risk for cardiovascular events, even in moderate-risk patients with normal to moderately elevated cholesterol levels. Data from trials of a broad range of antihypertensives reinforce the value of blood pressure (BP) management and indicate that some of these agents may have additional benefits beyond BP reduction. Similarly, meta-analyses of randomized trials confirm that antiplatelet therapy prevents serious cardiovascular events in a wide range of high-risk patients. Each of these interventions alone has been demonstrated to reduce the risk for vascular events by approximately 25 to 30%. A combination approach utilizing intensive risk-reducing therapy with more than one of these agents has the potential to reduce the risk for vascular events by as much as 75%. Combined with nonpharmacologic risk reduction strategies, including exercise, diet, and smoking cessation, an opportunity exists to reduce the incidence of both first and recurrent cardiovascular events dramatically. [source] | |||||||||||||||||||||||||